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Wen J, Zhao Y, Tang F, Cheng W, Peng J, Li Q, Pan H, Li H, Chen L. Full-term pregnancy with retroperitoneal giant mucinous cyst: A case report and literature review. Medicine (Baltimore) 2024; 103:e36979. [PMID: 38457602 PMCID: PMC10919471 DOI: 10.1097/md.0000000000036979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/22/2023] [Indexed: 03/10/2024] Open
Abstract
RATIONALE Retroperitoneal benign cysts during pregnancy are extremely rare and often remain asymptomatic until they attain a very large size. Diagnosis typically relies on a pathological tissue biopsy. The decision to pursue 1-step or 2-step surgical treatment should be tailored to each individual case rather than generalized. PATIENT CONCERNS This case report presents the unique scenario of a pregnant woman with a confirmed pregnancy complicated by a large retroperitoneal cyst. The patient had a retroperitoneal cyst during her initial pregnancy, which went undetected during the first cesarean section. However, it was identified during her second pregnancy by which time it had grown to 13.0 cm × 15.0 cm × 25.0 cm, and extended from the liver margin to right ovarian pelvic infundibulopelvic ligament. Consequently, it was removed smoothly during her second cesarean section. DIAGNOSES Postoperative pathology results indicated a massive retroperitoneal mucinous cystadenoma. INTERVENTIONS The giant retroperitoneal cyst was smoothly excised during the second cesarean delivery for 1-step surgical treatment. OUTCOMES Under the combined spinal and epidural anesthesia, a live female infant was delivered at 38 3/7 gestational weeks and the neonatal weight was 3200g. Under general anesthesia with endotracheal intubation, the giant retroperitoneal cyst was excised smoothly without complications. LESSONS The findings of this case report contribute to the understanding of the diagnostic modalities, surgical approaches and postoperative considerations of giant retroperitoneal cysts associated with pregnancy.
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Affiliation(s)
- Jiao Wen
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Wuhan University of Science and Technology, Wuhan, China
| | - Yun Zhao
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Tang
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenxing Cheng
- Wuhan University of Science and Technology, Wuhan, China
| | - Jing Peng
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qianyi Li
- Wuhan University of Science and Technology, Wuhan, China
| | | | - Hao Li
- Huazhong University of Science and Technology, Wuhan, China
| | - Lei Chen
- Huazhong University of Science and Technology, Wuhan, China
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Narita K, Kaneko H, Hasegawa F, Akao N, Kusafuka T, Desaki R, Ogura M, Hamada T, Asakawa K, Murata T. A giant liposarcoma originating from peripancreatic fat tissue with identification using 3D-CT angiography: a case report. Surg Case Rep 2024; 10:7. [PMID: 38185749 PMCID: PMC10772136 DOI: 10.1186/s40792-023-01797-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Liposarcoma originating from peripancreatic fat tissue is extremely rare. This case report presents a surgical case of a giant liposarcoma originating from peripancreatic fat tissue with origin identification using 3-Dimensional Computed Tomography Angiography (3D-CTA). CASE PRESENTATION A 59-year-old female was referred to our hospital with a giant abdominal tumor. Computed tomography revealed a 34 cm tumor composed of fatty tissue, exerting pressure on the posterior aspect of the pancreas. Suspecting liposarcoma, we planned for surgery. At first, the tumor appeared to be intra-abdominal tumor, based on the identification of the tumor's feeding artery as a branch of the dorsal pancreatic artery using 3D-CTA, we concluded that the liposarcoma originated from the peripancreatic fat tissue and situated in the retroperitoneum. During surgery, we observed a well-capsulated, elastic, yellowish mass without infiltration into surrounding tissues. We carefully dissected the tumor from the greater omentum and transverse mesocolon while preserving the tumor capsule. We ligated the feeding artery at the border with the pancreatic parenchyma and successfully completed the excision of the tumor. The resected specimen weighted 2620 g and was pathologically diagnosed as a well-differentiated liposarcoma. There was no injury to the tumor's capsule, and the surgical margins were negative. CONCLUSIONS In this report, we present an extremely rare case of a liposarcoma originating in the peripancreatic fat tissue. The use of 3D-CTA was instrumental in identifying the primary site of this giant tumor, enabling us to guide the surgery and achieve complete resection successfully.
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Affiliation(s)
- Kiyoshi Narita
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan.
| | - Hiroshi Kaneko
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Fumiya Hasegawa
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Nozomi Akao
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Tomoki Kusafuka
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Ryosuke Desaki
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Masaomi Ogura
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Takashi Hamada
- Department of Surgery, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Kana Asakawa
- Department of Pathology, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
| | - Tetsuya Murata
- Department of Pathology, JA Suzuka General Hospital, 1275-53 Yasuzukacho Yamanohana, Suzuka, Mie, 513-8630, Japan
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